How did you select the pilot site for EHR Implementation?
Our first EHR pilot site was selected before the CNEA grant was available. We worked with our vendor to purchase a small number of licenses that would allow us to get our feet wet with EHR. We decided to implement EHR at a new 3 provider facility we were opening. The new facility would only be open 20 hours a week in the beginning. We felt this would give us time to work out the bugs and processes in our system. It didn’t take long to realize new management, new employees, new facility, new software, new providers, new patients is too much news.
We picked our first CNEA implementation site for several reasons. The facility was closer geographically to our main office where the IT staff and EMR training staff reside. The staff is experienced and stable. The lead provider is a champion, participates in GVHC’s Quality Improvement Team, and was willing to become a super user.
Subsequent to receiving the grant we opened a Mobil Optometric Clinic. This was our easiest implementation to date. The equipment on the Bus is all digital, the provider was committed to becoming paperless, and the small number of staff made training easier. This site is billing using the EMR and PMS in a paperless fashion.
Our second CNEA implementation site also has a champion provider leader. This site has two providers and is a school based center. The provider does work occasionally at our initial pre CNEA pilot site. We felt having the provider participate in the implementation would improve communications between the two EMR enabled facilities. She too is becoming a super user.
The third CNEA implementation site is our largest and busiest location. This site has 12 very productive providers and is championed by our CMO. Our CMO was trained on EMR early on in the project. Although this was not the initial plan, it was critical as we need her participation in corporate decision making. The site staff has recently participated in the Optimizing Primary Care model, and they are excited to tackle a new project. We will be training the staff in 3 pods.
Our process of implementation has 2 phases. In phase I we first train the providers and staff how to use the e-prescribing system. We then allow the providers to advance towards 100% e-prescribing over no more than 9 weeks (this usually happens faster). While the providers are getting up to speed, we continue to train the support staff in additional duties. Our goal is by the time we start phase II with the provider staff, our support staff is ready to support them. During Phase II providers begin full charting, again advancing towards 100% charting over 12 weeks.
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1 comment:
Ray -
Really enjoyed your insight about "too much news"! On the surface, it seems to make so much sense: start a up a new clinic with electronic patient management processes and electronic patient records rather than have to convert/change later. However, when staff are still trying to figure out where the paper clips are and how the copier works, all these little things add up to an overload of unknowns. I've heard many similiar stories of change management becoming simply chaos management. Thanks for the post.
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